Nonarteritic Anterior Ischemic Optic Neuropathy Following COVID-19 Vaccination: A Case Report

Chung, Seung Ah; Yeo, Suji; Sohn, Sung-Yeon

doi:10.3341/kjo.2021.0128

Cited by 8 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Optic neuropathy is suspected as one of adverse events of the COVID-19 vaccine, which includes ON associated with or without demyelinating CNS diseases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], NA-AION [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], and NMOSD [ 8 , 9 ]. Lotan et al reviewed 14 case reports and 2 case series by electronic searches of the published literature regarding neuro-ophthalmological complications of COVID-19 vaccines and reported that optic neuritis was the most common, occurring in 61 of 76 cases (80.3%) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

2022

View full text Add to dashboard Cite

Background: We report a case of atypical unilateral optic neuritis after receiving the BNT162b2 mRNA-based COVID-19 vaccine. Case Presentation: An 86-year-old man complained of blurred vision and decreased visual acuity in his right eye 8 days after receiving the second BNT162b2 mRNA-based COVID-19 vaccine and was referred to our hospital. He also had pain with eye movement. Best corrected visual acuity (BCVA) in the right eye was 20/200 and critical flicker frequency dropped to 16 Hz. Relative afferent pupillary defect was positive and central scotomas were observed on visual field analysis. Fundus examination and SD-OCT revealed optic disc swelling and apparent thickening of the retinal nerve fiber layer around the optic disc in the right eye. Although either an increase in CRP or ESR on laboratory tests, demyelinating lesion on MRI, or positive of anti-MOG antibodies or anti-AQP4 antibodies were not observed, fluorescein angiography presented only hyperfluorescence of the optic disc in the right eye, but there were no findings such as papillary deficiency and choroidal delay that would suggest ischemic optic neuropathy. We diagnosed atypical optic neuritis developed after the SARS-CoV-2 mRNA-based vaccination and initiated oral corticosteroid therapy. One month later, the optic disc swelling disappeared and BCVA improved to 20/100; however, the central scotoma remained and no further improvement in visual function OD was obtained. Conclusions: An atypical acute idiopathic optic neuritis can occur after receiving the second vaccination with BNT162b2, which may present a limited response to corticosteroid therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

2022

View full text Add to dashboard Cite

show abstract

“…We finally obtained reports of 14 patients (16 eyes) from 9 centers, 1 of which had already been published in the literature. 12 …”

Section: Methodsmentioning

confidence: 99%

“…In Korea, where two recombinant mRNA vaccines (BNT162b2, Pfizer-BioNTech and mRNA-1273, Moderna) and two adenovirus vector-based vaccines (ChAdOx1 nCoV-19, Oxford-AstraZeneca and Ad26.COV2 Janssen, Johnson & Johnson) have been mainly distributed, a few cases of ocular disease after COVID-19 vaccination have been reported. 11 12 13 14 However, with the widespread distribution of vaccines, the need for a nationwide survey of ocular disease after COVID-19 vaccination has been raised.…”

Section: Introductionmentioning

confidence: 99%

Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background To report the clinical manifestations of non-arteritic anterior ischemic optic neuropathy (NAION) cases after coronavirus disease 2019 (COVID-19) vaccination in Korea. Methods This multicenter retrospective study included patients diagnosed with NAION within 42 days of COVID-19 vaccination. We collected data on vaccinations, demographic features, presence of vascular risk factors, ocular findings, and visual outcomes of patients with NAION. Results The study included 16 eyes of 14 patients (6 men, 8 women) with a mean age of 63.5 ± 9.1 (range, 43–77) years. The most common underlying disease was hypertension, accounting for 28.6% of patients with NAION. Seven patients (50.0%) had no vascular risk factors for NAION. The mean time from vaccination to onset was 13.8 ± 14.2 (range, 1–41) days. All 16 eyes had disc swelling at initial presentation, and 3 of them (18.8%) had peripapillary intraretinal and/or subretinal fluid with severe disc swelling. Peripapillary hemorrhage was found in 50% of the patients, and one (6.3%) patient had peripapillary cotton-wool spots. In eight fellow eyes for which we were able to review the fundus photographs, the horizontal cup/disc ratio was less than 0.25 in four eyes (50.0%). The mean visual acuity was logMAR 0.6 ± 0.7 at the initial presentation and logMAR 0.7 ± 0.8 at the final visit. Conclusion Only 64% of patients with NAION after COVID-19 vaccination have known vascular and ocular risk factors relevant to ischemic optic neuropathy. This suggests that COVID-19 vaccination may increase the risk of NAION. However, overall clinical features and visual outcomes of the NAION patients after COVID-19 vaccination were similar to those of typical NAION.

show abstract

“…NAION was reported after the Pfizer-BioNTech mRNA-based and AstraZeneca nonreplicating viral vector vaccines 138,139 . NAION was rarely reported to be associated with vaccination in the past.…”

Section: Neuro-ophthalmic Adverse Events To Coronavirus Disease 2019 ...mentioning

confidence: 99%

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Lin,

Sen,

Gupta

et al. 2023

Asia-Pacific Journal of Ophthalmology

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 was one of the most devastating public health issues in recent decades. The ophthalmology community is as concerned about the COVID-19 pandemic as the global public health community is, as COVID-19 was recognized to affect multiple organs in the human body, including the eyes, early in the course of the outbreak. Ophthalmic manifestations of COVID-19 are highly variable and could range from mild ocular surface abnormalities to potentially sight and life-threatening orbital and neuro-ophthalmic diseases. Furthermore, ophthalmic manifestations may also be the presenting or the only findings in COVID-19 infections. Meanwhile, global vaccination campaigns to attain herd immunity in different populations are the major strategy to mitigate the pandemic. As novel vaccinations against COVID-19 emerged, so were reports on adverse ophthalmic reactions potentially related to such. As the world enters a post-pandemic state where COVID-19 continues to exist and evolve as an endemic globally, the ophthalmology community ought to be aware of and keep abreast of the latest knowledge of ophthalmic associations with COVID-19 and its vaccinations. This review is a summary of the latest literature on the ophthalmic manifestations of COVID-19 and the adverse ophthalmic reactions related to its vaccinations.

show abstract

Nonarteritic Anterior Ischemic Optic Neuropathy Following COVID-19 Vaccination: A Case Report

Cited by 8 publications

References 29 publications

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Contact Info

Product

Resources

About